Abstract:
BACKGROUND:Metaplastic breast cancer (MBC) is characterized by chemoresistance and hematogenous spread. We sought to identify factors associated with improved MBC outcomes and increased likelihood of MBC diagnosis. METHODS:Women ≥ 18 years of age with stage I-III MBC and non-MBC diagnosed between 2010 and 2014 were identified in the National Cancer Data Base. Kaplan-Meier and multivariate Cox proportional hazards models were used to estimate associations with overall survival (OS). Multivariate logistic regression identified factors associated with MBC diagnosis. RESULTS:Overall, 2451 MBC and 568,057 non-MBC patients were included; 70.3% of MBC vs. 11.3% of non-MBC patients were triple negative (p < 0.001). Five-year OS was reduced among MBC vs. non-MBC patients for the entire cohort (72.7 vs. 87.5%) and among triple-negative patients (71.1 vs. 77.8%; both p < 0.001). In MBC, triple-negative (vs. luminal) subtype was not associated with worse OS (hazard ratio [HR] 1.16, 95% confidence interval [CI] 0.88-1.54, p = 0.28). Compared with non-MBC patients, MBC patients were more likely to receive mastectomy (59.0 vs. 44.9%), chemotherapy (74.1 vs. 43.1%), and axillary lymph node dissection (ALND; 35.2 vs. 32.2%, all p ≤ 0.001). MBC patients more frequently had negative ALND (pN0) than non-MBC patients (20.0 vs. 10.6%, p < 0.001). Among MBC patients, chemotherapy (HR 0.69, 95% CI 0.53-0.89, p = 0.004) and radiotherapy (HR 0.52, 95% CI 0.39-0.69, p < 0.001) were associated with improved survival, while ALND was associated with decreased survival (HR 1.37, 95% CI 1.06-1.77, p = 0.02). CONCLUSIONS:MBC patients had worse survival than non-MBC patients, independent of receptor status, suggesting that MBC may confer an additional survival disadvantage. Multimodal therapy was associated with improved outcomes, but ALND was not and may be overutilized in MBC.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Ong CT,Campbell BM,Thomas SM,Greenup RA,Plichta JK,Rosenberger LH,Force J,Hall A,Hyslop T,Hwang ES,Fayanju OMdoi
10.1245/s10434-018-6533-3subject
Has Abstractpub_date
2018-08-01 00:00:00pages
2249-2260issue
8eissn
1068-9265issn
1534-4681pii
10.1245/s10434-018-6533-3journal_volume
25pub_type
杂志文章abstract:BACKGROUND:The diagnostic phase of care is an anxiety-provoking and stressful experience for the potential breast cancer patient. A multidisciplinary team of breast cancer specialists embarked on a new initiative to pilot a Rapid Diagnosis and Support (RADS) Clinic to coordinate the diagnostic workup and nursing suppor...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-3120-5
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Major hepatectomy for intrahepatic cholangiocarcinoma (ICC) sometimes involves resection of major hepatic veins, which might result in the future liver remnant (FLR) congestion. The necessity and efficacy of resection and reconstruction of the middle hepatic vein (MHV) during right or left hemihepatectomy fo...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5384-z
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Rad51 is a protein which plays a vital role in DNA double-strand break repair and maintenance of telomeres. However, the underlying mechanism for its action in esophageal squamous cell carcinoma (ESCC) remains unclear. PATIENTS AND METHODS:Eighty-seven patients with ESCC were enrolled in this study. Express...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-08043-x
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Local recurrence occurs in 10% to 20% of patients with extremity soft tissue sarcomas despite optimal treatment. The association of local recurrence with subsequent survival is controversial and conflicting. There is a need for a staging system to predict outcome in this subset of patients and also to plan o...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/s10434-001-0278-z
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Preoperative devascularization might improve local control and thus the outcome of patients with soft tissue sarcoma (STS). The multikinase inhibitor pazopanib has antiangiogenic effects and is approved for treating metastatic STS. We conducted a trial of preoperative pazopanib therapy in high-risk STS. MET...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07183-4
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:The enhanced esthetics and demonstrated oncologic safety of nipple-sparing mastectomy (NSM) in selected patients have resulted in increased rates among patients with locally advanced breast cancer and/or additional risk factors (obesity, prior radiation, surgery). Limited data exist on complication and recon...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07560-z
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Remote home monitoring might fill the perceived surveillance gap after hospital discharge. However, it is unclear whether older oncologic patients will be able to use the required new digital technologies. The study aimed to assess the feasibility of postoperative remote home monitoring for this population. ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08705-1
更新日期:2021-01-01 00:00:00
abstract:PURPOSE:Patients with locally advanced cervical cancer (LACC) are usually treated with concurrent chemoradiotherapy. Extended-field chemoradiotherapy is indicated in case of para-aortic node involvement at initial assessment. 18-Fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18-FDG PET/CT) i...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-011-1583-9
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:In a Dutch phase II trial conducted between 2006 and 2010, short-course radiotherapy followed by systemic therapy with capecitabine, oxaliplatin, and bevacizumab as neoadjuvant treatment and subsequent radical surgical treatment of primary tumor and metastatic sites was evaluated. In this study, we report th...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-5897-0
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Clinical practice guidelines have been developed to improve melanoma patient care. However, it is unclear whether failure to comply with these standards (either excessive or inadequate treatment) increases morbidity or relapse rates. Therefore, we undertook this study to evaluate the effect of variance from ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-0021-0
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Survival for Child's A patients with hepatocellular cancer (HCC) and macroscopic vascular invasion (MVI) has been reported as approximately 8.1 months with sorafenib. The role of surgery for these patients remains controversial. METHODS:The records of all patients undergoing resection of HCC at a single cen...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-013-3074-7
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Circulating ('blood-borne') tissue factor (TF) is implicated in the pathogenesis of several chronic conditions, most notably cardiovascular disease, diabetes, and cancer. Full-length TF is an integral membrane protein, while alternatively spliced TF (asTF) can be secreted and, owing to its unique C-terminus,...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4592-2
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Esophageal cancer is an aggressive cancer with poor prognosis. However, little is known about the immune response in the tumor microenvironment after neoadjuvant chemotherapy. PURPOSE:To investigate the immunological impact of neoadjuvant chemotherapy in the tumor microenvironment of esophageal squamous cel...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-011-1906-x
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:The benefits of hepatic transplantation (HT) compared with hepatic resection (HR) in treating hepatocellular carcinoma (HCC) in patients with cirrhosis are controversial. The aim of this study was to compare the results of these therapeutic options. METHODS:The charts of all patients with cirrhosis who unde...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02557525
更新日期:2002-11-01 00:00:00
abstract::There is increasing evidence regarding extracapsular lymph node involvement (LNI) as a prognostic factor for recurrence and poor prognosis in gastrointestinal malignancies. The aim of this study was to assess the prevalence and prognostic impact of LNI in patients with resected esophageal cancer, comparing adenocarcin...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-008-0248-9
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Postesophagectomy diaphragmatic hernia (DH) is an uncommon problem but an important one to recognize and treat because of the risk of significant complications such as incarceration and strangulation. Diaphragmatic hernia appears to occur more frequently following transhiatal esophagectomy (THE) than after t...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4366-x
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new technology for delivering intraperitoneal chemotherapy. It is generally assumed that with PIPAC, the ratio of peritoneal to systemic drug concentration is superior to liquid hyperthermic intraperitoneal chemotherapy (HIPEC). To date, no direct...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07695-z
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Pathological responses of neoadjuvant chemotherapy (NCT) are associated with survival outcomes in patients with breast cancer. Previous studies constructed models using out-of-date variables to predict pathological outcomes, and lacked external validation, making them unsuitable to guide current clinical pra...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-09214-x
更新日期:2020-10-23 00:00:00
abstract:BACKGROUND:As tumor burden increases in colorectal cancer, treatment complexity progresses from colectomy to hepatectomy and lastly to cytoreductive surgery with heated intraperitoneal chemotherapy (CRS-HIPEC). The aim of this study was to evaluate whether disparities exist in the access to progressively more complex s...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4220-6
更新日期:2015-05-01 00:00:00
abstract:PURPOSE:Retroperitoneal sarcomas (RPS) are rare malignancies, comprising just 10-15 % of all soft-tissue sarcomas. These are challenging tumors to treat, with surgical resection being the only modality capable of providing a cure. This study analyzed the management and survival of patients resected at a large academic ...
journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/s10434-014-3616-7
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate whether patient satisfaction, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, is associated with short-term outcomes after major cancer surgery. MATERIALS AND METHODS:We first used national Medicare claims to identi...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-6049-2
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Laparoscopic pancreaticoduodenectomy with venous reconstruction is not commonly performed due to its technical challenges. In this video, we focus on the technical aspects for how to perform this procedure safely. METHODS:In a 69-year-old female with jaundice and diarrhea, a computed tomography scan showed ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-018-6762-5
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:To investigate the prognostic value of positive-to-negative changes in hormone receptor (HR) status after neoadjuvant chemotherapy (NCT) in patients with HR-positive breast cancer. METHODS:Data from 224 stage II-III breast cancer patients with positive HR status before NCT who had residual disease in the br...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2318-2
更新日期:2012-09-01 00:00:00
abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 评论,杂志文章
doi:10.1245/s10434-018-6961-0
更新日期:2018-12-01 00:00:00
abstract:PURPOSE:To determine the risk factors related to adnexal involvement in endometrial cancer (EC) and its implications for ovarian preservation in young women. METHODS:We analyzed a series of 802 patients who were treated at AC Camargo Cancer Center from July 1991 to July 2017. Patients who had peritoneal or systemic di...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08261-8
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:We seek to determine whether laparoscopic hyperthermic intraperitoneal chemoperfusion (LS-HIPEC) improves overall survival (OS) in patients with gastric and gastroesophageal adenocarcinoma and low-volume peritoneal metastasis compared with standard of care treatment. PATIENTS AND METHODS:We reviewed data fr...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08968-8
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Incidence rates of hypoparathyroidism and vocal cord paralysis are high following central compartment reoperation, but few prospective studies have assessed morbidities and factors predictive of hypocalcemia after reoperation. We investigated recurrence patterns, morbidity, and factors predictive of postoper...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1470-9
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Surgical resection with curative intent for giant cell tumor of bone (GCTB) may be associated with severe morbidity. This interim analysis evaluated reduction in surgical invasiveness after denosumab treatment in patients with resectable GCTB. METHODS:Patients with primary or recurrent GCTB, for whom the in...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4634-9
更新日期:2015-09-01 00:00:00
abstract::The number of early gastric cancer (EGC) cases has been increasing because of improved diagnostic procedures. Applications of function-preserving gastric cancer surgery may therefore also be increasing because of its low incidence of lymph node metastasis, excellent survival rates, and the possibility of less-invasive...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,评审
doi:10.1245/s10434-013-2931-8
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Surgery is the standard treatment for primary, gastrointestinal stromal tumor (GIST); however, surgical resection often is not curative, particularly in large GIST. Five years after complete removal of their tumor, approximately half of treated patients relapse. Imatinib, an oral tyrosine kinase inhibitor (T...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1053-9
更新日期:2010-10-01 00:00:00